Heights University Hospital

All Charges

Charge

Type

Setting

Price

MANGANESE

Facility

$168.75

Service Code	HCPCS 83785
Hospital Charge Code	3030900
Hospital Revenue Code	301
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$86.35
Rate for Payer: Aetna Medicare Advantage	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.65
Rate for Payer: Cigna Commercial	$26.65
Rate for Payer: Cigna Medicare Advantage	$13.32
Rate for Payer: Clover Medicare Advantage	$25.32
Rate for Payer: EmblemHealth Commercial	$79.95
Rate for Payer: Humana Medicare Advantage	$27.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.94
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.31
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.25
Rate for Payer: Wellcare Medicare Advantage	$26.65

MANGANESE

Facility

$174.15

Service Code	HCPCS 83785
Hospital Charge Code	38477175
Hospital Revenue Code	301
Min. Negotiated Rate	$26.12
Max. Negotiated Rate	$26.12
Rate for Payer: Qualcare PPO/HMO/WC	$26.12

MANGANESE,24 HOUR URINE

Facility

$168.75

Service Code	HCPCS 83785
Hospital Charge Code	3030902
Hospital Revenue Code	301
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$86.35
Rate for Payer: Aetna Medicare Advantage	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.65
Rate for Payer: Cigna Commercial	$26.65
Rate for Payer: Cigna Medicare Advantage	$13.32
Rate for Payer: Clover Medicare Advantage	$25.32
Rate for Payer: EmblemHealth Commercial	$79.95
Rate for Payer: Humana Medicare Advantage	$27.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.94
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.31
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.25
Rate for Payer: Wellcare Medicare Advantage	$26.65

MANGANESE,24 HOUR URINE

Facility

$168.75

Service Code	HCPCS 83785
Hospital Charge Code	3030902
Hospital Revenue Code	301
Min. Negotiated Rate	$25.31
Max. Negotiated Rate	$25.31
Rate for Payer: Qualcare PPO/HMO/WC	$25.31

MANGANESE INJ 0.1MG/ML 10ML

Facility

$3.85

Hospital Charge Code	6025035
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.16
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.50
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$1.93

MANGANESE INJ 0.1MG/ML 10ML

Facility

$3.85

Hospital Charge Code	6025035
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

MANGANESE INJ 0.1MG/ML 10ML

Facility

$3.85

Hospital Charge Code	6025001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.16
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.50
Rate for Payer: Oxford Commercial	$1.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$1.93

MANGANESE INJ 0.1MG/ML 10ML

Facility

$3.85

Hospital Charge Code	6025001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

MANGANESE URINE

Facility

$168.75

Service Code	HCPCS 83785
Hospital Charge Code	3001874A
Hospital Revenue Code	301
Min. Negotiated Rate	$25.31
Max. Negotiated Rate	$25.31
Rate for Payer: Qualcare PPO/HMO/WC	$25.31

MANGANESE URINE

Facility

$168.75

Service Code	HCPCS 83785
Hospital Charge Code	3001874A
Hospital Revenue Code	301
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$86.35
Rate for Payer: Aetna Medicare Advantage	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$65.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.65
Rate for Payer: Cigna Commercial	$26.65
Rate for Payer: Cigna Medicare Advantage	$13.32
Rate for Payer: Clover Medicare Advantage	$25.32
Rate for Payer: EmblemHealth Commercial	$79.95
Rate for Payer: Humana Medicare Advantage	$27.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.94
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.31
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.65
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.25
Rate for Payer: Wellcare Medicare Advantage	$26.65

MANIFOLD 3 PORT

Facility

$20.25

Hospital Charge Code	270663920
Hospital Revenue Code	272
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$3.04
Rate for Payer: Qualcare PPO/HMO/WC	$3.04

MANIFOLD 3 PORT

Facility

$20.25

Hospital Charge Code	270663920
Hospital Revenue Code	272
Min. Negotiated Rate	$2.63
Max. Negotiated Rate	$10.12
Rate for Payer: Aetna Commercial	$6.08
Rate for Payer: Aetna Medicare Advantage	$6.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.16
Rate for Payer: Cigna Commercial	$10.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.63
Rate for Payer: Oxford Commercial	$10.12
Rate for Payer: Qualcare PPO/HMO/WC	$3.04
Rate for Payer: UnitedHealthcare Commercial	$10.12

MANIFOLD UNIV.SET-UP 39TUBING

Facility

$28.00

Hospital Charge Code	270331479
Hospital Revenue Code	272
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$8.40
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$14.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$14.00

MANIFOLD UNIV.SET-UP 39TUBING

Facility

$28.00

Hospital Charge Code	270331479
Hospital Revenue Code	272
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

MANIFOLD W/COLLECTION SOCK

Facility

$34.30

Hospital Charge Code	270676801
Hospital Revenue Code	272
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

MANIFOLD W/COLLECTION SOCK

Facility

$34.30

Hospital Charge Code	270676801
Hospital Revenue Code	272
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$17.15
Rate for Payer: Aetna Commercial	$10.29
Rate for Payer: Aetna Medicare Advantage	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.75
Rate for Payer: Cigna Commercial	$17.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.46
Rate for Payer: Oxford Commercial	$17.15
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$17.15

MANIP ELBOW W ANESTH

Facility

$13,711.90

Service Code	HCPCS 24300
Hospital Charge Code	16000682
Hospital Revenue Code	360
Min. Negotiated Rate	$1,782.55
Max. Negotiated Rate	$4,113.57
Rate for Payer: Aetna Commercial	$4,113.57
Rate for Payer: Aetna Medicare Advantage	$4,113.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,496.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,496.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,496.53
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,782.55
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,056.78
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

MANIP ELBOW W ANESTH

Facility

$13,711.90

Service Code	HCPCS 24300
Hospital Charge Code	16000682
Hospital Revenue Code	360
Min. Negotiated Rate	$2,056.78
Max. Negotiated Rate	$2,056.78
Rate for Payer: Qualcare PPO/HMO/WC	$2,056.78

MANIP SHLDR JOINT,UNDER ANESTH

Facility

$13,711.90

Service Code	HCPCS 23700
Hospital Charge Code	16000545
Hospital Revenue Code	360
Min. Negotiated Rate	$2,056.78
Max. Negotiated Rate	$2,056.78
Rate for Payer: Qualcare PPO/HMO/WC	$2,056.78

MANIP SHLDR JOINT,UNDER ANESTH

Facility

$13,711.90

Service Code	HCPCS 23700
Hospital Charge Code	16000545
Hospital Revenue Code	360
Min. Negotiated Rate	$1,782.55
Max. Negotiated Rate	$4,113.57
Rate for Payer: Aetna Commercial	$4,113.57
Rate for Payer: Aetna Medicare Advantage	$4,113.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,496.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,496.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,496.53
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,782.55
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,056.78
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

MANIPULATE ANKLE UNDER GEN AN

Facility

$14,501.75

Service Code	HCPCS 27860
Hospital Charge Code	16000630
Hospital Revenue Code	360
Min. Negotiated Rate	$1,864.00
Max. Negotiated Rate	$7,791.93
Rate for Payer: Aetna Commercial	$4,350.52
Rate for Payer: Aetna Medicare Advantage	$4,350.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,697.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,697.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,697.95
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,885.23
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.26
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

MANIPULATE ANKLE UNDER GEN AN

Facility

$14,501.75

Service Code	HCPCS 27860
Hospital Charge Code	16000630
Hospital Revenue Code	360
Min. Negotiated Rate	$2,175.26
Max. Negotiated Rate	$2,175.26
Rate for Payer: Qualcare PPO/HMO/WC	$2,175.26

MANIPULATE FINGER W/ANESTH

Facility

$6,331.60

Service Code	HCPCS 26340
Hospital Charge Code	16000475
Hospital Revenue Code	360
Min. Negotiated Rate	$949.74
Max. Negotiated Rate	$949.74
Rate for Payer: Qualcare PPO/HMO/WC	$949.74

MANIPULATE FINGER W/ANESTH

Facility

$6,331.60

Service Code	HCPCS 26340
Hospital Charge Code	16000475
Hospital Revenue Code	360
Min. Negotiated Rate	$823.11
Max. Negotiated Rate	$3,829.26
Rate for Payer: Aetna Commercial	$1,899.48
Rate for Payer: Aetna Medicare Advantage	$1,899.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,614.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,614.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,614.56
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$823.11
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$949.74
Rate for Payer: UnitedHealthcare Commercial	$1,686.00

MANIPULATE KNEE JNT UNDR ANES

Facility

$32,127.31

Service Code	HCPCS 27570
Hospital Charge Code	16000215
Hospital Revenue Code	360
Min. Negotiated Rate	$4,819.10
Max. Negotiated Rate	$4,819.10
Rate for Payer: Qualcare PPO/HMO/WC	$4,819.10

Know your out-of-pocket cost for care.

All Charges